Gout

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Overview

Gout is a certain type of arthritis that is characterized by severe, sudden onset of joint pain, tenderness, swelling and redness, often at the joint of the base of the big toe. These symptoms usually come and go in episodes, and cause immense discomfort and pain to the patient.

Causes

Uric acid is a metabolite within the blood that is removed by the kidneys. Overproduction or under-removal of uric acid can lead to its accumulation within the body as uric acid crystals, that gather around joints and lead to intense inflammation in those areas during an acute attack.

Risk factors for this health condition include:

  • Diet rich in meat, seafood, alcohol and fruit sugar (fructose)
  • Obesity
  • Age
  • Male gender
  • Recent surgery or trauma
  • Medical conditions (high blood pressure, kidney and heart diseases, diabetes etc)
  • Medications (thiazide diuretics, aspirin, anti-rejection drugs)
  • Family history

Symptoms

The signs and indications of gout occur suddenly and often at night. They include:

  • Severe joint pain
  • Lasting discomfort after the pain subsides
  • Redness of the involved joint
  • Swelling of the involved joint
  • Restricted range of motion of the involved joint

Recurrent gout attacks, formation of nodules of crystals under skin called tophi, and urate kidney stones are some common serious complications of gout.

Diagnosis

After a patient history and examination of involved joints, blood levels of uric acid  and joint fluid aspirate analysis can often conclude the diagnosis. Other tests that are used to evaluate gout are:

  • X-ray imaging
  • Ultrasound
  • Dual-energy CT scan

Treatment

It is often beneficial to modify lifestyle and diet to prevent further attacks of gout. Intake of ample amount of fluids, reduction of weight, and avoidance of food and drinks rich in uric acid can aid recovery.

Drugs used to manage and prevent future acute attacks are NSAIDs, Colchicine, and corticosteroids. Drugs that block uric acid production such as xanthine oxidase inhibitors (allopurinol, febuxostat) and drugs that increase removal of uric acid (probenecid) can be used to avoid complications associated with gout.

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